Hepatitis C Cases In Rural Wisconsin Underscore Drug Link

Yes, hepatitis C is big among baby boomers. And the feds are moving toward a recommendation that all of them get tested at least once for the infection.

But new hepatitis C cases are cropping up in young people, too, and some of them live in out-of-the-way places that haven't been hotbeds for the illness.

The Wisconsin Division of Public Health noticed a strange uptick to 24 cases a year recently, from eight, or so, annually before. Some cases of the liver disease were bad enough to land people in emergency rooms, an unusual situation. Those cases provided the initial tip that something was up, Marisa Stanley, an epidemiologist with the state told Shots.

Researchers looked at 25 cases of hepatitis C, all involving people under 30, in 2010. The investigators interviewed 17 of them and found that 16 had either injected or snorted illicit drugs. Many were also sharing their gear.

"People were using all sorts of different drugs," Stanley said. "It wasn't just sharing needles. It was sharing all sorts of drug preparation, snorting and injecting equipment."

The hepatitis C virus is pretty hardy, said Sheila Guilfoyle, a colleague of Stanley's, and drug paraphernalia contaminated with it can be hazardous for a while.

Stanley and Guilfoyle were among the authors of the report about the cases in the latest issue of Morbidity and Mortality Weekly Report.

Now a couple of things seem worth pointing out. The problems were concentrated in a half-dozen rural counties, not cities where hepatitis C was already recognized as a problem.

Several of the people who injected drugs started out with opioids, such as morphine or oxycodone, before moving on to heroin, which is less expensive.

So the uptick in hepatitis C cases appeared to be tied, at least in part, to an increase in abuse of injected narcotics that began with legal drugs. "We've looked at this as a substance abuse issue," Stanley said. But, she added, the link with hepatitis C cases means "we have to look at it as a bigger public health issue."